Objective: To evaluate the evidence for and against the effectiveness of reflexology for treating any medical condition.
Data sources: Six electronic databases were searched from their inception to February 2009 to identify all relevant randomised controlled trials (RCTs). No language restrictions were applied.
Study selection and data extraction: RCTs of reflexology delivered by trained reflexologists to patients with specific medical conditions. Condition studied, study design and controls, primary outcome measures, follow-up, and main results were extracted.
Data synthesis: 18 RCTs met all the inclusion criteria. The studies examined a range of conditions: anovulation, asthma, back pain, dementia, diabetes, cancer, foot oedema in pregnancy, headache, irritable bowel syndrome, menopause, multiple sclerosis, the postoperative state and premenstrual syndrome. There were > 1 studies for asthma, the postoperative state, cancer palliation and multiple sclerosis. Five RCTs yielded positive results. Methodological quality was evaluated using the Jadad scale. The methodological quality was often poor, and sample sizes were generally low. Most higher-quality trials did not generate positive findings.
Conclusion: The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition.
- 1. Thomas KS, Nicholl JP, Coleman P. Use and expenditure on complementary medicine in England — a population based survey. Complement Ther Med 2001; 9: 2-11.
- 2. Gravett P. Making sense of English in alternative medicine. Edinburgh: Chambers, 1993.
- 3. Goodwin H. Reflex zone therapy. In: Rankin-Box D, editor. Complementary health therapies. A guide for nurses and the caring profession. London: Chapman Hall, 1988.
- 4. Ernst E, Köder K. An overview of reflexology. Eur J Gen Pract 1997; 3: 52-57.
- 5. Stephenson N, Dalton JA, Carlson J. The effect of foot reflexology on pain in patients with metastatic cancer. Appl Nurs Res 2003; 16: 284-286.
- 6. Quattrin R, Zanini A, Buchini S, et al. Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes. J Nurs Manag 2006; 14: 96-105.
- 7. Stephenson NL, Swanson M, Dalton J, et al. Partner-delivered reflexology: effects on cancer pain and anxiety. Oncol Nurs Forum 2007; 34: 127-132.
- 8. Hattan J, King L, Griffiths P. The impact of foot massage and guided relaxation following cardiac surgery: a randomized controlled trial. J Adv Nurs 2002; 37: 199-207.
- 9. Frankel BSM. The effect of reflexology on baroreceptor reflex sensitivity, blood pressure and sinus arrhythmia. Complement Ther Med 1997; 5: 80-84.
- 10. Vicar AJ, Greenwood CR, Fewell F, et al. Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: a pilot study in healthy individuals. Complement Ther Clin Pract 2007; 13: 137-145.
- 11. Samuel CA, Ebenezer IS. The effects of reflexology on pain threshold and tolerance in an ice-pain experiment in healthy human subjects [abstract]. Complement Ther Med 2008; 16: 236.
- 12. Jadad AR, Moore RA, Carrol D, et al. Assessing the quality of reports of randomized clinical trials — is blinding necessary? Control Clin Trials 1996; 17: 1-12.
- 13. Engquist A, Vibe-Hansen H. [Zone therapy and plasma cortisol during surgical stress] [Danish]. Ugeskr Laeger 1977; 139: 460-462.
- 14. Lafuente A, Noguera M, Puy C, et al. Effekt der Reflexzonenbehandlung am Fuss bezüglich der prophylaktischen Behandlung mit Flunarizin bei an Cephalea-Kopfschmerzen leidenden Patienten [German]. Erfahrungsheilkunde 1990; 39: 713-715.
- 15. Petersen NL, Faurschou P, Olsen OT, Svendsen UG. Foot zone therapy and bronchial asthma: a controlled clinical trial. Ugeskr Laeger 1992; 154: 2065-2068.
- 16. Oleson T, Flocco W. Randomized controlled study of premenstrual symptoms treated with ear, hand, and foot reflexology. Obstet Gynecol 1993; 82: 906-911.
- 17. Wang XM. [Treating type II diabetes mellitus with foot reflexotherapy] [Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1993; 13: 536-538.
- 18. Kesselring A, Spichiger E, Müller M. [Foot reflexology: an intervention study] [German]. Pflege 1998; 11: 213-218.
- 19. Hodgson H. Does reflexology impact on cancer patients’ quality of life? Nurs Stand 2000; 14: 33-38.
- 20. Stephenson NL, Weinrich SP, Tavakoli AS. The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer. Oncol Nurs Forum 2000; 27: 67-72.
- 21. Brygge T, Heinig JH, Poulsen LK. Refloxology and bronchial asthma. Respir Med 2001; 95: 173-179.
- 22. Williamson J, White A, Hart A, Ernst E. Randomised controlled trial of reflexology for menopausal symptoms. BJOG 2002; 109: 1050-1055.
- 23. Ross CS, Hamilton J, Macrae G, et al. A pilot study to evaluate the effect of reflexology on mood and symptom rating of advanced cancer patients. Palliat Med 2002; 16: 544-545.
- 24. Tovey PA. A single-blind trial of reflexology for irritable bowel syndrome. Br J Gen Pract 2002; 52: 19-23.
- 25. Mollart L. Single-blind trial addressing the differential effects of two reflexology techniques versus rest, on ankle and foot oedema in late pregnancy. Complement Ther Nurs Midwifery 2003; 9: 203-208.
- 26. Siev-Ner I, Gamus D, Lerner-Geva L, Achiron A. Reflexology treatment relieves symptoms of multiple sclerosis: a randomized controlled study. Mult Scler 2003; 9: 356-361.
- 27. Poole H, Glenn S, Murphy P. A randomised controlled study of reflexology for the management of chronic low back pain. Eur J Pain 2007; 11: 878-887.
- 28. Holt J, Lord J, Acharya U, et al. The effectiveness of foot reflexology in inducing ovulation: a sham-controlled randomised trial. Fertil Steril 2009; 91: 2514-2519. [Epub 2008; Jun 20.]
- 29. Hodgson NA, Anderson S. The clinical efficacy of reflexology in nursing home residents with dementia. J Altern Complement Med 2008; 14: 269-275.
- 30. Mackereth PA, Booth K, Hillier VF, Caress A-L. Reflexology and progressive muscle relaxation training for people with multiple sclerosis: a crossover trial. Complement Ther Clin Pract 2009; 15: 4-21.
- 31. Grealish L, Lomasney A, Whiteman B. Foot massage: a nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nurs 2000; 23: 237-243.
- 32. Berkson D. The foot book. Healing the body through reflexology. New York: Barnes Harper and Row, 1977.
- 33. Berker M. Is chest pain affected by reflexology intervention [BPhil dissertation]? Exeter: University of Exeter, 1993.
- 34. White AR, Williamson J, Hart A, Ernst E. A blinded investigation into the accuracy of reflexology. Complement Ther Med 2000; 8: 166-172.
- 35. Baerheim A, Algrøy R, Skogedal KR, et al. [Feet — a diagnostic tool?] [Norwegian]. Tidsskr Nor Laegeforen 1998; 5: 753-755.
- 36. Strohecker J, editor. Alternative medicine. The definitive guide. Puyallup, Wash: Future Medicine Publications, 1994.
- 37. Ingham ED. Stories the feet can tell. St Petersburg, Fla: Ingham Publishers, 1938.
- 38. Norman L. The reflexology handbook. Bath: Bath Press, 1988.
- 39. Gill GV, Redmond S, Garratt F, Paisey R. Diabetes and alternative medicine: cause for concern. Diabet Med 1994; 11: 210-213.
- 40. McCaffrey AM, Pugh GF, O’Connor BB. Understanding patient preference for integrative medical care: results from patient focus groups. J Gen Intern Med 2007; 22: 1500-1505.
- 41. Ernst E. Whatever became of empathy? Perfusion 1996; 4: 121.
- 42. Tallis R. The mystery and the paradox of scientific medicine. Clin Med 2008; 8: 75-78.
- 43. Hughes D, Ladas E, Rooney D, Kelly K. Massage therapy as a supportive care intervention for children with cancer. Oncol Nurs Forum 2008; 35: 431-442.
- 44. Wang MY, Tsai PS, Lee PH, et al. The efficacy of reflexology: systematic review. J Adv Nurs 2008; 62: 512-520.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.